Background: Understanding psychopathology in transitional age youth (TAY) requires a complex model, incorporating familial vulnerability and environmental factors. A trans-diagnostic and dimensional approach seems the most appropriate. Transition_psy study aims to assess factors playing a role in TAY psychopathology and to define predictors.Materials and methods: This article presents part of the Transition_psy study results, a case-control observational study. Youth aged 17 years old were recruited between June 2020 and December 2021, from both clinical [clinical population (CP) group] and non-clinical settings [non-clinical population (NCP) group]. Participants completed self-report questionnaires. The primary outcome to assess TAY psychopathology was the Youth-Self Report (YSR). We evaluated care needs with the Health of The Nation Outcome Scales For Children And Adolescents (HoNOSCA-SR) and quality of life with the World Health Organization Quality of Life – BREF (WHOQoL-BREF). Exposure factors included familial vulnerability, childhood, and present environmental factors, such as first-degree family history of psychopathology, the Childhood Trauma Questionnaire (CTQ) and the Family Assessment Device (FAD). YSR scores were compared, between groups, according to exposure factors with ANOVA and linear regression. We performed best subsets selection of multivariable analyses based on the Akaike Information Criterion. This study was registered with ClinicalTrials.gov (Identifier: NCT04333797).Results: A total of 220 TAY (CP = 106, NCP = 114) were included in the study. Participants were aged 17 years old. The majority were female (69.1%), single (96.8%), and born in Belgium (82.3%). Clinical data were all significantly different between CP and NCP groups. YSR scores were found statistically different according to group (p < 0.001), first-degree family history of psychopathology (p < 0.001), CTQ (p < 0.001), and FAD (p < 0.001). Predictive dimensional model suggested that TAY psychopathology can be predicted by group, CTQ and FAD. Significant positive correlation was found between YSR and HoNOSCA (rho = 0.81) and negative correlation between YSR and physical and psychological health (rho = −0.69 and −0.71, respectively).Conclusion: This study findings allowed to present a predictive dimensional model on TAY psychopathology, including belonging to a clinical population at transitional age, childhood trauma, and family dysfunction. Further research is needed to replicate Transition_psy study results in other samples. The proposed model could be used in clinical practice to improve assessment of TAY psychopathology.
2 September 2024 in Early Intervention in Psychiatry
Background: Psychiatric disorders often emerge during adolescence or young adulthood, leading to significant disability among youth. The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is critical for individuals experiencing emerging psychopathology, with delayed access to care negatively impacting long‐term outcomes. Accessing mental health services for adolescents and young adults is often complex and delayed due to challenges in service visibility, accessibility and appropriateness.Methods: This study examines the care trajectories of individuals consecutively accessing the early detection and intervention (EDI) centre C'JAAD (Evaluation Centre for Young Adults and Adolescents) in Paris (France) over the year 2021. The main goal was to clarify the role of this EDI centre in the continuity of care and transition to AMHS. Data about their history of care, hospitalisations and referral sources were collected retrospectively.Results: The sample comprised 194 individuals, with 57.2% males and a median age of 20 years. Most patients (67.5%) were ≥18 years old upon arrival, with 31% in a situation of not being in education, employment, or training (NEET). Over one‐third (35.2%) had prior psychiatric hospitalisations. Patients were mainly referred to our EDI centre from other hospital departments (42.3%). Regarding care in CAMHS, 50.3% of the total sample had medical follow‐up during childhood, of whom 41.9% had discontinued care upon arrival at the EDI centre. The median onset age of care in CAMHS was 14, with a median duration of 12 months. Adult patients experienced an approximately 3‐year gap between the end of CAMHS care and assessment at the EDI centre.Discussion: The sample's characteristics resemble those of other EDI centres, but concerns persist regarding referral timing and the NEET status of many youths. Lack of prior medical follow‐up and challenges in transitioning to AMHS underscore the need to enhance care continuity and address difficulties in accessing care during the transition to adulthood.
Introduction: Emerging adults are a particularly at-risk population in mental health. The primary aim of the Transition_psy study is to evaluate changes in mental health care need and quality of life during transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). The relationship between these changes and genetic or environmental vulnerabilities and clinical dimensions representing risk and protective factors to the development of psychopathology will be analyzed. We also aim to explore how each factor plays, specifically, a role in developing internalizing and externalizing symptoms, in order to predict the most common paths of psychopathology in transitional age youth (TAY).Methods and Analysis:Transition_psy is a multicenter prospective longitudinal cohort study. The transversal and trans-diagnostic approach consists of a dimensional evaluation: 300 youth at the age of 17 will be included in a cohort of in-patients, out-patients and control group. Participants will be assessed at baseline (T0) and 24 months later (T1). The primary objective to determine changes in self-rated Health Of The Nation Outcome Scales For Children And Adolescents (HONOSCA-SR) and WHO Quality of Life-BREF (WHOQOL-BREF) scores between T0 and T1. Pearson correlation and mediation analysis will be performed. A secondary objective analysis using mediation and moderation models with several dimensional aspects, including self-reported and cognitive measures, will be conducted to disentangle the potential relationships between the two scores.Discussion: Transition from CAMHS to AMHS occurs at a crucial age in terms of the continuum between adolescent and adulthood psychopathology. This collaborative and cohesive protocol between CAMHS and AMHS represents the first national cohort study about Transition Psychiatry in French-speaking Belgium.Ethics and Dissemination: The study protocol was approved by the Institutional Review Boards (IRB) of the three participating sites. Results will be published in peer-reviewed journals and disseminated at national and international conferences. This trial was registered in ClinicalTrials.gov (Identifier: NCT04333797) on 3 April 2020.
Introduction: The authors describe a 14-year-old adolescent presenting a first manic episode begun during COVID-19 lockdown measures. The patient was experiencing extreme psychological discomfort about the lockdown measures.